My 8 year old daughter started racing this year in the U10 class and recently I have noticed that she wheezes after a climb or hard effort. We usually ride for no more than 45 minutes to an hour, and I have never noticed her wheezing until we have been on the bike for at least 30 minutes. I don't have any experience with asthma, but my wife has brothers with asthma. Does this sound like she may have asthma? If so, how do they test for it and is it dangerous for her to race? I know this is you area of expertise, so I appreciate any advice you can give me.

Yes, your daughter's symptoms could be entirely consistent with asthma. Here is what I do in my evaluation of a child in working up a possible diagnosis of asthma. I take a detailed history focusing on things that may trigger symptoms of coughing, wheezing, chest tightness and/or shortness of breath. Does your daughter get any or all of these symptoms with colds, exposure to fur bearing animals, perfumes, cleaning agents, exercise, cold air, dust, tobacco smoke, laughing hard or crying hard and/or rigorous exercise? When she gets a cold, does it always seem to go to her chest? Does she or any of her immediate family members have any of the above symptoms and triggers? Is there a history of hay fever, eczema or other allergy problems in the immediate family members? If there are positive answers on these items, this increases the likelihood she will have asthma. She is old enough to undergo pulmonary function testing with lung volumes and airflow resistance pre- and post- bronchodilator. These may reveal airway obstruction that is reversible and will confirm the diagnosis of asthma. If my history, physical and laboratory testing indicate asthma, then given her symptoms, she would likely benefit from a combination therapy with inhaled corticosteroids and long acting bronchodilators. There are two medications of this class that are safe and effective, Advair and Symbacort. I use both of them heavily in my Pediatric Pulmonology practice and I am quite pleased with the results my patients get.

Seek an evaluation by a Pediatric Pulmonologist. Let me know what geographic area you live in and I can give you some names of some good Pedi Pulmonologists that you can seek an evaluation with. I am reluctant to recommend an Allergist Immunologist that is not in a major University Medical Center with an Allergy Immunology Fellowship program. Most that are in private practice still adhere to allergy testing then allergy shots therapy modality and the current medical research findings are indicating that allergy shot therapy not to be effective in asthma. I do know of some very competent Allergist/ Immunologist who would not send your daughter down the allergy shot road if you would like an evaluation by an Allergist/Immunologist.

Good news for your daughter is that if she does have asthma, she can be productive and competitive throughout her life with the excellent asthma medications we have available now. Peruse this site to get an idea of famous people and athletes with asthma. http://www.nlm.nih.gov/hmd/breath/Faces_asthma/facespres.html

Ft. Worth: At Cook's Children's Medical Center Pediatric Pulmonologists Maynard Dyson, MD or Jim Cunningham, MD 682-885-6299. I have worked with both of these fine physicians and can recommend them.

Lubbock: No Pediatric Pulmonologist there. However, not too far north in Amarillo, my practice in Pediatric Pulmonology is located at Texas Tech Medical Center 1400 S. Coulter St. Amarillo, 79106 806-354-5437. I could get your daughter worked in within the next 1-2 weeks. Let me know and I will have my secretaries book you in if you want to head to the Panhandle. Bring the mountain bikes and make a weekend trip of it. I can get you in on a Friday so yo can go play in Palo Duro Canyon on the weekend.